- CLINICAL CORE The Mayo ADRC Clinical Core recruits, evaluates and follows longitudinally persons with cognitive disorders as well as cognitively normal persons who serve as controls. The Clinical Core is led by 4 behavioral neurologists (one in Jacksonville and 3 in Rochester) who have considerable expertise in the cognitive syndromes of the Alzheimer's disease (AD) and non-Alzheimer degenerative spectrum, as well as the cerebrovascular spectrum. In the past 4 years, the Mayo ADRC has made significant contributions in the areas of genetics and imaging of AD, the genetics, imaging and clinical characterization of the syndromes of frontotemporal lobar degeneration, and the clinical and imaging characterization of Dementia with Lewy Bodies. We have participated in numerous national consortia for clinical trials (industry and ADCS), genetics (ADGC) and imaging (ADNI). We have had excellent success with recruiting and retaining our research participants. In the past 4 years, we have recruited African American participants into a variety of projects and trials. Moreover, in conjunction with our Outreach, Recruitment and Education Core, we have a great increase in the number of African American participants who have agreed to brain donation after death. Although we do not require autopsy consent from our participants, our overall autopsy rate was 54%. For the new grant cycle, we intend to continue our activities in these focus areas. Thus, our specific aims include recruiting and following persons in the AD degenerative spectrum, persons with Dementia with Lewy Bodies and persons with frontotemporal lobar degeneration (FTLD) spectrum from preclinical to dementia. We will also recruit cognitively normal volunteers who agree to undergo brain imaging and cognitively normal persons with sleep disorders such as REM Sleep Behavior Disorder that are known to be predictive of synucleinopathy. This latter group will be recruited in order to address an understudied area, namely the preclinical manifestations of Lewy Body Disease. Our interest in this unique group of individuals takes advantage of our longstanding involvement in both mild cognitive impairment and in the Lewy Body Disease spectrum. We will also devote the necessary resources and effort for enhancing our recruiting and following of African American normal volunteers and patients with disorders in the AD, DLB and FTLD spectra. In support of another of our aims, we will obtain DNA on cognitively normal, MCI and dementia participants (AD, LBD, FTLD) in order to supply ADRC-related genetics projects with genetic material. All of the persons who are recruited and followed by the Mayo ADRC will have an evaluation by a behavioral neurologist, a neuropsychological assessment battery that includes the UDS as well as additional procedures, and multimodal brain imaging for the majority of participants. The Clinical Core will continue to work closely with the Neuropathology Core and ADRC related projects that require clinical- pathological correlation.